While making a home visit she complains to you of experiencing increasing joint stiffness. You learn she has been doing a lot of reading lately. Based on these data you conclude she

Correct Answer: A

Rationale: The correct answer is A) needs to exercise involved joints periodically. Joint stiffness can result from prolonged, static postures, such as reading for extended periods. Encouraging the patient to periodically move and exercise the involved joints can help alleviate stiffness and improve circulation. This is supported by the concept of maintaining joint mobility and preventing stiffness through movement. Option B) needs to take long walks twice a day is incorrect as it does not directly address the issue of joint stiffness related to prolonged reading. While walking can be beneficial for overall health, it may not specifically target the stiffness caused by reading. Option C) is a chronic complainer is a distractor and not related to the patient's reported joint stiffness. This option lacks relevance to the scenario presented. Option D) needs to rest involved joints for one hour at a time is incorrect because prolonged rest can actually contribute to joint stiffness. While rest is important, in this case, gentle movement and exercises are more appropriate to address the stiffness issue. In an educational context, understanding the importance of movement and exercise in maintaining joint health is crucial for healthcare providers. Encouraging patients to engage in regular physical activity can help prevent and manage joint stiffness, promoting overall well-being. It is essential to tailor recommendations to each individual's specific situation and activities to optimize health outcomes.

Correct Answer: A

Rationale: The correct answer is A) Nonsteroidal anti-inflammatory medications and colchicine. In the treatment of acute gout attacks, nonsteroidal anti-inflammatory drugs (NSAIDs) help reduce inflammation and pain, while colchicine is specifically effective in treating gout by reducing inflammation and pain associated with crystal deposition in the joints. This combination targets the underlying cause of the acute gout attack and provides symptomatic relief. Option B) Allopurinol and aspirin is incorrect because allopurinol is a medication used for long-term management of gout by lowering uric acid levels and preventing future attacks, not for treating acute symptoms. Aspirin can actually worsen gout symptoms by interfering with uric acid excretion. Option C) Antibiotics and acetaminophen is also incorrect as antibiotics are not indicated for acute gout attacks unless there is an accompanying infection. Acetaminophen may provide some pain relief but does not address the underlying inflammatory process of gout. Option D) Bisphosphonates and calcium are used in the treatment of osteoporosis and have no role in managing acute gout attacks. Educationally, understanding the appropriate management of acute gout attacks is crucial for healthcare professionals to provide effective care and alleviate patient discomfort. This question highlights the importance of differentiating between long-term gout management and acute attack treatment, emphasizing the need for targeted therapies based on the underlying pathophysiology of the condition.

Correct Answer: A

Rationale: In this scenario, the nurse suspects that the client is experiencing problems with circulation, which is the correct answer (Option A). Weak pulses, dusky color in the ankles, and significant local edema are indicative of impaired blood flow to the lower extremities. This could be due to conditions such as peripheral vascular disease or deep vein thrombosis, which can lead to serious complications if not addressed promptly. Option B, problems with sensation, is incorrect in this case because the symptoms described are more closely related to circulatory issues rather than sensory deficits. Problems with sensation would typically involve issues such as numbness, tingling, or loss of feeling in the affected area. Option C, problems with mobility, is also incorrect as the symptoms presented do not directly point to issues with the client's ability to move. While impaired circulation can impact mobility in the long term if left untreated, it is not the primary concern based on the symptoms provided. Option D, problems with pain, is not the most likely issue as the symptoms described are more indicative of compromised blood flow rather than pain perception. While the client may eventually experience pain if circulation is severely compromised, the initial symptoms point more towards circulatory issues. From an educational perspective, understanding the signs and symptoms of circulatory problems in the lower extremities is crucial for nurses working in various clinical settings. Recognizing these indicators early can help prevent complications such as tissue damage, ulceration, and even amputation. Nurses should be able to differentiate between circulatory issues, sensory deficits, mobility problems, and pain to provide timely and appropriate care to their patients.

Correct Answer: D

Rationale: In the context of positioning a client with a fracture, it is crucial to ensure that the joints are positioned in an anatomic alignment to prevent damage to the peripheral nerves and blood vessels, making option D the correct answer. When joints are not in proper alignment, there is a risk of compression or injury to the surrounding nerves and blood vessels due to increased pressure or tension on these structures. This can lead to complications such as impaired circulation, numbness, tingling, or even more serious nerve damage. Option A, to prevent deep vein thrombosis, is incorrect in this scenario because deep vein thrombosis is more related to immobility and blood clot formation in the deep veins, rather than joint alignment. Option B, to facilitate lung expansion and prevent pooling of secretions, is not directly related to joint alignment in a client with a fracture. Option C, to prevent the escalation of pain and swelling, is important but not the primary reason for ensuring anatomic alignment of joints. Educationally, understanding the rationale behind proper positioning in clients with fractures is essential for nurses to provide safe and effective care, prevent complications, and promote optimal healing and recovery. It highlights the importance of attention to detail and precision in nursing interventions to promote positive patient outcomes.

Correct Answer: A

Rationale: The correct answer is A) Swelling due to the initial trauma may make the injury seem more severe than it actually is. A more accurate assessment will be made once the swelling goes down. This response is the best because in cases of acute trauma such as an automobile accident, immediate swelling and inflammation can mask the true extent of the injury. It is important to wait until the swelling decreases to assess the patient's condition accurately. Jumping to conclusions or making assumptions based on initial presentation can lead to incorrect diagnoses and inappropriate interventions. Option B is incorrect because it is a simplistic explanation that does not consider the complexity of the situation. It does not provide a comprehensive or accurate assessment of the patient's condition. Option C is incorrect because while rehabilitation centers may be beneficial for some patients, the immediate concern in this situation is assessing the extent of the injury and providing appropriate acute care. Option D is incorrect because it is not relevant to the immediate medical assessment and care needed for the patient's current condition. It is important to focus on the patient's current symptoms and needs rather than placing blame or discussing preventative measures at this moment. In an educational context, this question highlights the importance of thorough assessment and critical thinking in emergency situations. It emphasizes the need to consider factors such as swelling and initial presentation when evaluating a patient's condition. It also underscores the significance of avoiding premature conclusions and ensuring a comprehensive evaluation before determining a course of action.